Patients with chronic migraine demonstrated higher rates of comorbid sleep disorders such as obstructive sleep apnea (OSA) and insomnia compared with patients with episodic migraine, according to study findings presented at the 2022 American Headache Society (AHS) Annual Scientific Meeting, held from June 9-12, in Denver, Colorado, and virtually.
Dysregulation of common nervous system pathways contribute to the development of both migraine and sleep disorders, increasing the probability of comorbid association between these 2 conditions.
Using collected data on 1,853,595 patients from the Leaf research database at the University of Washington Medical Center in Seattle between October 2015 and October 2021, the researchers conducted a retrospective, single-center, epidemiological analysis of comorbid sleep conditions and migraine.
Of these patients, 8709 had chronic migraine without aura, while 41,235 had episodic migraine. Despite increased prevalence of episodic migraine, comorbid sleep disorders occurred less frequently in patients with episodic compared with chronic migraine.
In this study, 1173 (13%) of the 8709 patients with chronic migraine also had OSA, while only 3084 (7%) of the 41,235 patients with episodic migraine had OSA (P <.00001). Following a similar pattern, 1782 (20%) patients with chronic migraine had comorbid insomnia, while 7425 (18%) with episodic migraine were diagnosed with insomnia (P <.00001). Additionally, patients experiencing chronic migraine also presented with restless leg syndrome (n=354), hypersomnia (n=315), and narcolepsy/cataplexy (n=27).
The researchers also observed that chronic migraine and comorbid sleep disorders predominantly impacted women. Approximately 6937 (80%) of the 8709 patients diagnosed with chronic migraine were female. Correspondingly, 849 (72%) of the 1173 patients with comorbid chronic migraine and OSA were female, along with 1454 (82%) of the 1782 patients with comorbid chronic migraine and insomnia.
The researchers recommend patients should be assessed for sleep disorders, such as OSA and insomnia, if they experience headache, especially chronic migraine.
“Based on these findings, we recommend that all patients presenting with headaches, especially with [chronic migraine], should be evaluated for the presence of sleep disorders such as OSA and insomnia,” the researchers suggested.
“There are many interventions that can address comorbid sleep disorders, and treatments can decrease and potentially modify migraine transformation from episodic to chronic and improve patient well-being,” the researchers concluded.
Kim Y, Murinova N. Comorbid sleep disorders in patients with migraine: A single-center study. Presented at: AHS 2022 Annual Scientific Meeting; June 9-12, 2022; Denver, Colorado. Poster 44.